Agenda item

One question has been received for the Panel from a member of the public.

A member of the public, Paula Riseborough had asked a question relating to Agenda Item 7 (RUH – Ambulance Service / Winter Planning / Treatment Waiting Times). A copy of the question and subsequent answer can be found attached as an online appendix to these minutes.

Councillor Joanna Wright addressed the Panel on the subject of Dentistry and said that there is a severe lack of NHS services locally. She said that where services were available in a number of cases she was aware of significant delays.

She recounted a letter from a member of the public that said that having been unable to find an NHS dentist, had found an ‘affordable’ one and had received treatment that included two teeth being removed and a filling at a total cost of £330.

The letter also told of how her daughter had been waiting two years for a number of teeth to be removed at hospital. It said that on finally receiving an appointment in September she had six teeth removed even though was advised that one could be saved. The daughter asked for the tooth to be removed as she did not have a dentist as could not afford to go private.

Councillor Wright provided the Panel with further evidence from a member of the public and the poor care their son had received following the removal of a wisdom tooth.

He had a double surgical wisdom tooth extraction in August under general anaesthetic at the Royal United Hospital, Bath. He was first referred for the operation by his dentist in 2019 and after a couple of postponements he received a phone call in August 2022 and was told that he could have the operation on Monday 8th August. In the following week leading up to the operation, they did not receive a letter with the date, time, or advance instructions.

They called the hospital the Friday before the operation (5th August) to check if he needed to prepare in any way. During this call, they were given the important information that he must not eat after 7am and not drink water after 10 am on the day of the operation and that he must be collected after the operation by somebody and have someone with him for 24 hours following the general anaesthetic.

On the day of the operation they were told that nobody could wait with their son prior to the surgery. They said he was quite anxious about the procedure, especially as he had never had a general anaesthetic before. The anxiety and lack of support made this a difficult experience for him.

At around 3.30pm their son messaged to say that he was going into the operation. We were given no idea of how long it would be. I was told to call after an hour. After an hour and a half they called to see if he was ready to be collected and were told first of all that they did not know where he was, and then that he was still in recovery and to call back in an hour. After another hour they were told that he was still not back and that they had 33 patients and only 12 beds and that he was still in recovery awaiting a bed.

Finally, the ward staff said that they could come in and collect him, but when they arrived at the hospital following a 20-minute drive they were told he was not back yet. When he did return he appeared still very sedated and only semi-conscious. A kind member of the recovery team had brought him to the ward.

There was a shift changeover. The next ward nurse told them that he had to pass urine 3 times before he could be discharged. This was rather disappointing.

Fairly quickly another nurse arrived and said they should leave as it was getting late (it was about 8.30pm by this time) This nurse gave them a sheet of paper which stated who had performed the operation and what painkillers he had to take home with him. She said there was no aftercare and if we had any problems to call our GP.

They had no idea how to care for a mouth in this condition with this level of swelling as well. No one told them what medications or painkillers he had been given last or when they could give him the next painkillers.

They returned home and searched online for suggestions as to how to care for their son the best they could. There was a lot of swelling, pain, very bruised mouth, neck, and face. He was totally unable to function that evening due to the meds he had been given and the impact on his face and mouth.

On the 3rd day following the procedure he began to complain of a bad sore throat. They called their GP and he said it could be a postoperative infection. He suggested that they should start on antibiotics in case it was an infection and they made an appointment to be seen that afternoon.

By 1.30pm he began feeling absolutely terrible. He literally felt as if he was going to die. He felt he was going to vomit, he was shaking, hot and cold to touch, pins and needles in all his limbs, tingling with what also felt like a fire in his chest, very confused, very afraid. They made the decision to go to the GP practice immediately. The duty doctor said that they needed to go to A&E immediately and see the maxillofacial surgical team. He called the department to prepare for his arrival and he prepared a letter for us to take stating that their son was ‘Tachycardic and had hypertension and that he was ‘concerned about a post-operative infection and given the systemic impact would be grateful for your review’. As soon as I had the letter in my hands, I drove to A&E.

Once they arrived at A&E with the preparations of the duty doctor their son was seen and triaged very quickly and taken rapidly up to the Maxillofacial department where a team of 4 were waiting for him. The lead maxillofacial surgeon said that there was a lot of food debris around the surgical sites and the gums were looking red and that he couldn’t rule out an infection. The surgical sites were cleaned, and a large blood clot was removed by suction.

Their son was given a course of antibiotics and given a special syringe with a long tube and antiseptic mouthwash to enable him to clean the surgical sites after any food. This was what he did subsequently, and his recovery continues to improve and be good.

Councillor Wright said that she believed that there is a problem with the general availability of dentists locally and that she was hoping to attend a webinar on 27^th October entitled ‘Eliminating Dental Deserts’.

The Chairman commented that this was recognised as a national problem and that he would see if the matter could form an agenda item for a future meeting.

Councillor Liz Hardman said that she would support Councillor Wright in attending the event.

The Democratic Services Officer advised that any training requests should come directly to Democratic Services, as the Panel does not have the power or budget to allocate this resource.

The Chairman said that he would support the request and members of the Panel were also in agreement.